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David L. Galbut
Ernest A. Traad
Malcolm J. Dorman
Paul L. DeWitt
Parry B. Larsen
Paul A. Kurlansky
Thomas O. Gentsch
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Ann Thorac Surg 1990;49:195-201
© 1990 The Society of Thoracic Surgeons


Articles

Seventeen-year experience with bilateral internal mammary artery grafts

David L. Galbut, MD*, Ernest A. Traad, MD, Malcolm J. Dorman, MD, Paul L. DeWitt, MD, Parry B. Larsen, MD, Paul A. Kurlansky, MD, Jaclyn H. Button, MS, Joan M. Ally, ARNP, Thomas O. Gentsch, MD

Cardiovascular and Thoracic Surgical Associates, Miami Heart Institute, Miami, Florida USA

* Address reprint requests to Dr Galbut, 1150 NW 14th St, Suite 207, Miami, FL 33136.

The internal mammary artery (IMA) is being recognized as the conduit of choice for myocardial revascularization. From January 1972 through June 1988, 1,087 patients received bilateral IMA and supplemental vein grafts. There were 917 men (84.4%) and 170 women (15.6%) with a mean age of 62.4 years (range, 29 to 84 years). Three hundred ninety-four patients (36.2%) had unstable angina, and 194 (17.8%) had left main coronary artery stenosis greater than 50%. In all, 3,741 coronary grate were performed, with a mean of 3.4 per patient. Hospital mortality was 2.7% (29 patients). Hospital complications included reoperation for bleeding, 19 patients (1.7%); sternal infection, 16 patients (1.5%); respiratory failure, 35 patients (3.2%); perioperative myocardial infarction, 22 patients (2.0%); and stroke, 20 patients (1.8%). Postoperative arteriography in 53 patients (mean postoperative time, 53.0 months) showed that 92.1% ([equation]) of the left IMA and 84.9% ([equation]) of the right IMA grafts were patent. Follow-up was completed on 1,058 hospital survivors. There were 82 late deaths (7.8%). The actuarial survival for patients discharged from the hospital was 80.0% ± 3.2% (plus or minus standard error of the mean) at 10 years and 60.0% ± 5.0% at 15 yean. At follow-up, 866 patients (90.3%) were asymptomatic and in New York Hearl Association class I and 68 (7.1%) were in class II. This longitudinal analysis demonstrates that bilateral IMA grafting has a low operative risk and provides excellent long-term functional improvement and survival.




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Asian Cardiovascular and Thoracic Annals, June 1, 1995; 3(2): 71 - 74.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
O. Jegaden, A. Eker, P. Montagna, J. Ossette, G. De Gevigney, G. Finet, A. S. Pierre, D. Revel, R. Itti, and P. H. Mikaeloff
Risk and results of bypass grafting using bilateral internal mammary and right gastroepiploic arteries
Ann. Thorac. Surg., April 1, 1995; 59(4): 955 - 960.
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E. Sivertssen, M. Abdelnoor, and N. B. Fjeld
Prolonged Aortic Cross-Clamping Time and Cardiopulmonary Bypass Time Have a Gradient Effect on Early Mortality in Open-Heart Surgery
Vascular and Endovascular Surgery, March 1, 1995; 29(2): 91 - 97.
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R. A. de Jesus and R. D. Acland
Anatomic study of the collateral blood supply of the sternum
Ann. Thorac. Surg., January 1, 1995; 59(1): 163 - 168.
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J. Thorac. Cardiovasc. Surg.Home page
S. Chocron, J.-P. Etievent, F. Schiele, F. Clement, K. Alwan, A. Cordier, N. Schipman, and J.-L. Mourand
The Y graft: Myocardial revascularization with both internal thoracic arteriesEvaluation of eighty cases with coronary angiographic assessment
J. Thorac. Cardiovasc. Surg., October 1, 1994; 108(4): 736 - 740.
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Ann. Thorac. Surg.Home page
F. S. Joyce, P. M. McCarthy, P. C. Taylor, D. M. Cosgrove III, and B. W. Lytle
Cardiac reoperation in patients with bilateral internal thoracic artery grafts
Ann. Thorac. Surg., July 1, 1994; 58(1): 80 - 85.
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Ann. Thorac. Surg.Home page
A. M. Calafiore, G. Di Giammarco, N. Luciani, N. Maddestra, E. Di Nardo, and R. Angelini
Composite arterial conduits for a wider arterial myocardial revascularization
Ann. Thorac. Surg., July 1, 1994; 58(1): 185 - 190.
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Ann. Thorac. Surg.Home page
E. Berreklouw, J. P. A. M. Schonberger, J. H. Bavinck, V. J. Verwaal, E. L. Koldewijn, F. van Der Linden, I. Van der Tweel, and J. J. Bredee
Similar hospital morbidity with the use of one or two internal thoracic arteries
Ann. Thorac. Surg., June 1, 1994; 57(6): 1564 - 1572.
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Ann. Thorac. Surg.Home page
D. Navia, D. M. Cosgrove III, B. W. Lytle, P. C. Taylor, P. M. McCarthy, R. W. Stewart, E. R. Rosenkranz, and F. D. Loop
Is the internal thoracic artery the conduit of choice to replace a stenotic vein graft?
Ann. Thorac. Surg., January 1, 1994; 57(1): 40 - 44.
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J. Thorac. Cardiovasc. Surg.Home page
G.-W. He, W. H. Ryan, T. E. Acuff, R. T. Bowman, M. B. Douthit, C.-Q. Yang, and M. J. Mack
Risk factors for operative mortality and sternal wound infection in bilateral internal mammary artery grafting
J. Thorac. Cardiovasc. Surg., January 1, 1994; 107(1): 196 - 202.
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J. I. Aramendi, E. Castellanos, A. O. de Salazar, A. Onate, F. Munoz, and M. Antonana
Myocardial Revascularization with the Gastroepiploic Artery
Vascular and Endovascular Surgery, November 1, 1993; 27(9): 673 - 679.
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G. M. Palatianos, H. Bolooki, M. D. Horowitz, M. H. Lowery, S. P. Rosenthal, S. K. C. Chandarlapaty, G. N. Sfakianakis, and G. A. Kaiser
Sequential internal mammary artery grafts for coronary artery bypass
Ann. Thorac. Surg., November 1, 1993; 56(5): 1136 - 1140.
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Ann. Thorac. Surg.Home page
J. A. M. van Son, F. Smedts, P. C. M. de Wilde, N. H. J. Pijls, L. Wong-Alcala, K. Kubat, G. Tavilla, and L. K. Lacquet
Histological study of the internal mammary artery with emphasis on its suitability as a coronary artery bypass graft
Ann. Thorac. Surg., January 1, 1993; 55(1): 106 - 113.
[Abstract] [PDF]


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Ann. Thorac. Surg.Home page
J. M. Cunningham, M. A. Gharavi, R. Fardin, and R. A. Meek
Considerations in the skeletonization technique of internal thoracic artery dissection
Ann. Thorac. Surg., November 1, 1992; 54(5): 947 - 950.
[Abstract] [PDF]


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Ann. Thorac. Surg.Home page
M. Carrier, J. Gregoire, F. Tronc, R. Cartier, Y. Leclerc, and L.-C. Pelletier
Effect of internal mammary artery dissection on sternal vascularization
Ann. Thorac. Surg., January 1, 1992; 53(1): 115 - 119.
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Ann. Thorac. Surg.Home page
D. L. Galbut, E. A. Traad, M. J. Dorman, P. L. DeWitt, P. B. Larsen, P. A. Kurlansky, J. H. Button, J. M. Ally, and T. O. Gentsch
Bilateral internal mammary artery grafts in reoperative and primary coronary bypass surgery
Ann. Thorac. Surg., July 1, 1991; 52(1): 20 - 28.
[Abstract] [PDF]


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Ann. Thorac. Surg.Home page
N. T. Kouchoukos, T. H. Wareing, S. F. Murphy, C. Pelate, and W. G. Marshall Jr
Risks of bilateral internal mammary artery bypass grafting
Ann. Thorac. Surg., February 1, 1990; 49(2): 210 - 219.
[Abstract] [PDF]




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